DESCRIPTION: The applicant's academic career demonstrates a longterm commitment to patientoriented research, extensive expertise in the study of the pathophysiology of age related cardiovascular disorders that disproportionately afflict older adults including heart failure with preserved systolic function and a successful record in mentoring residents, cardiology fellows and junior faculty in geriatrics and cardiology. The career plan of the applicant is to expand his research interests to multidisciplinary studies of age related cardiovascular conditions by focusing on heart failure with a normal ejection fraction, which accounts for more than half of the cases of heart failure in the United States and that afflicts predominately older adults. During the tenure of this award, the applicant will gain further training in genetics through formal coursework at the Mailman School of Public Health, strengthen existing and form new collaborative relationships with basic and clinical investigators at Columbia University, and institute a successful mentoring program for young clinical investigators from geriatrics and cardiology that will foster collaborative interdisciplinary investigations. The latter will be achieved by the creation of the Greater New York Geriatric Cardiology Consortium (GNYGCC) aimed at improving the care of older adult patients with cardiovascular disease by organizing and delivering a curriculum in geriatric cardiology as part of professional medical education activities and subsequently by performing innovative, investigatorinitiated, multicenter collaborative clinical investigation. The proposed mentoring program consists of three other components: 1) intensive individualized training in patientoriented research;2) Columbia University didactic programs on clinical trial design, data analysis, grant writing, and ethics;3) critical review by a team of patient oriented research experts. Awarding a Midcareer Investigator Award in Patient Oriented Research will provide critically needed protected time to achieve these career goals. Columbia provides a strong institutional environment for support of the applicant's career development. The Department of Internal Medicine and Division of Cardiology have committed to protect e50% of the applicant's time for patientoriented research and mentoring. The proposed aims are to evaluate: (1) whether targeting anemia, one of many extracardiac factors that could contribute to the syndrome of HFNEF, is associated with improved ventricular function, functional capacity and health status. (2) for potential differences in pathophysiologic mechanisms that cause or contribute to anergia (lack of energy) in heart failure subjects stratified by a preserved or a reduced ejection fraction and (3) ventricular mechanics and functional capacity using use of noninvasive pressure volume analysis and actigraphy in older adults undergoing percutaneous aortic valve replacement. The proposed studies will advance applicant career development and provide a mechanism by which trainees can acquire the necessary skills to launch a research career and collect data to support grant applications. The ultimate goal is to facilitate the development of a new generation of investigators from both cardiology and geriatrics that can pursue clinical research in the arena of aging cardiovascular disease. PUBLIC HEALTH RELEVANCE: Cardiovascular Disease remains the leading cause of mortality in the United States with a majority of those afflicted being older adults. The broad goal of this program is to train the next generation of academic clinical cardiovascular investigators who will focus on cardiovascular disorders that disproportionately afflict older adults in order to improve the outcomes among these individuals.